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The Hormone Cure by Sara Gottfried, MD (book excerpt)


Excerpted from The Hormone Cure by Sara Gottfried, MD. Copyright © 2013 by Sara Gottfried, MD. Excerpted with permission by Scribner, a Division of Simon & Schuster, Inc.

 

How to Find and Work Collaboratively with Practitioners for Your Hormone Cure  (Appendix D)

I’m a big fan of etiquette scripts when it comes to charged or difficult conversations. Scripts help me with a starting point, with someone else’s skillful ideas about what might be particularly useful in a given situation. For instance, say you have an acquaintance you don’t know well who tells you she just got diagnosed with cancer. You say, “That’s big.” And pause. You listen. You hear what she has to say. You don’t rush in with your own brush with cancer, or how you cared for your mom with metastatic breast cancer, or how you can imagine how they feel. Just, rather simply: “That’s big.” In this section, I’ll share scripts that my patients have found helpful with their other health providers.

I’m told often by women in my practice that there’s something very challenging about asserting yourself with your doctors when they dismiss your hormonal symptoms or decline to perform the tests you’ve reasonably requested.

I understand the mainstream doctors’ beef—I trained in the same system. After getting educated for so many years, and then, finally, having your own medical practice, you want to have a little authority. You recommend smart things, hopefully change lives, and establish caring and long-term relationships. But all day long, in those seven minute appointments, while American doctors are dispensing advice and rules, there’s often not much room for dialogue or partnership.

Here are some of the characteristics of a doctor who works collaboratively and won’t treat you paternalistically.

  • Is a keen listener. Not in a hurry to interject his or her own opinion.
  • Stays current with the literature. Ask if they know about the latest thyroid guidelines from chapter 9 on what defines a normal thyroid-stimulating hormone.
  • Understands nuance. Do they hear your symptoms, attune to your narrative, and then consider your labs? Non-collaborative doctors prefer to treat labs only.
  • Has a right-sized ego. Do they get defensive with your suggestions? Get a bit hot under the collar when you kindly notice they didn’t wash their hands in front of you at the beginning of the appointment?
  • Has time to address your concerns. Or is the hand on the doorknob when you work up the nerve to mention your libido or irritable mood?

Here are some scripts that I suggest as conversation starters.

  • “I just read a book about how to fix hormone problems, and I learned a lot. I brought you a copy in case you are interested. I know we don’t have much time today, but I would like to discuss it at my next appointment, and what my problems might be. Would you be willing to discuss it next time?” (Note: This is how I first read Dr. Uzzi Reiss’s book, Natural Hormone Balance. It works!)
  • “I’ve read a lot about hormones and am trying to make myself an educated consumer. I read in a particular book, by a doctor who specializes in hormones, that it’s important to look beyond some of the standard tests to really understand what’s going on. Because I’m experiencing [insert your symptoms], I wonder if you’d be willing to order a blood test for me.”
  • “I’ve been reading a book about hormone imbalance and how it relates to . . . [fill in the blank: cortisol, estrogen, testosterone, progesterone, insulin, leptin, vitamin D, thyroid]. I have these three symptoms of . . . [fill in the blank: high cortisol, high or low estrogen]. Would you be willing to order a test for me?”
  • If your doctor declines to perform testing, stand your ground. Be polite but assertive. “These references show there’s a link between . . . I’d really like to pursue testing to get to the bottom of this.” Or “Can you explain to me why it’s not worthwhile to test? I have seventeen references here that document the link between high cortisol and high blood pressure, high fasting glucose, fatigue, and belly fat, so I’d prefer to test.” Then pause.
  • If your doctor then says something along the lines of “I don’t believe in adrenal fatigue” or “Why don’t you just try this antidepressant?,” you can also recommend the citations I’ve compiled for practitioners at http://thehormonecurebook.com/practitioners.

If your doctor continues to refuse, you might ask if he or she can refer you to someone who’d be willing to order the tests, or, alternatively, you might consider the following websites to find a doctor who practices integrative medicine.

  • Members of the American College for the Advancement of Medicine: http://www.acamnet.org. (Scroll down to use “Physician+Link” to find a doctor in your area.)

 

 

Sara Gottfried, M.D., is a Harvard-educated physician and board-certified gynecologist who treats the root cause of problems, not just symptoms. A nationally-recognized yoga teacher, Gottfried, founder, The Gottfried Institute, teaches women how to balance their hormones naturally. She has been features in Yoga Journal, Glamour, and Cosmopolitan magazines and in the award-winning film, YogaWoman.  She is a married mom to two daughters and the New York Times bestselling author of The Hormone Cure & The Hormone Reset Diet.  Her latest book is entitled Younger.